AIM: Cardiovascular disease and mental illness commonly co-occur in later life, but it is unknown how early these associations arise. We aimed to determine the extent to which: (i) childhood mental health is associated with functional and structural cardiovascular risk phenotypes and adiposity in late childhood/adolescence, and (ii) associations between mental health and cardiovascular phenotypes may be explained by differential body mass index. METHODS: This cross-sectional study drew on three longitudinal community-based cohort studies (two enriched for overweight/obesity) in metropolitan Melbourne, Australia, with harmonized follow-up in 2014...

AIM: Self-harm and suicidal behaviour is most prevalent during adolescence, but little is known about the risk profile of adolescents admitted to hospital for suicidal behaviour. Young people who self-harm are at an increased risk of mortality compared to those who do not self-harm; adolescents admitted to hospital for suicidal behaviour are particularly at risk. The aim of this study was to generate a risk profile of adolescents admitted to hospital with suicidal behaviour. METHODS: We conducted a 12-month retrospective audit of adolescent admissions to the mental health inpatient unit at a tertiary children's hospital in Melbourne, Australia...

AIM: Subclinical hypothyroidism is defined as elevated thyroid-stimulating hormone (TSH) levels with the normal concentrations of thyroxine (T4) or free thyroxine (fT4), and its clinical significance is unclear. The purpose of this study is to investigate the prevalence of subclinical hypothyroidism in children and adolescents and determine the relationship between lipid profiles, insulin resistance and thyroid hormones. METHODS: A retrospective, cross-sectional study was performed using data from a subset of the KNHANES VI...

Cystic fibrosis (CF) is the most common, life-shortening, genetic illness affecting children in Australia and New Zealand. The genetic abnormality results in abnormal anion transport across the apical membrane of epithelial cells in a number of organs, including the lungs, gastrointestinal tract, liver and genito-urinary tract. Thus, CF is a multi-system disorder that requires a multi-disciplinary approach. Respiratory disease is the predominant cause of both morbidity and mortality in patients with CF. However, there are significant and clinically relevant gastrointestinal, liver, pancreatic and nutritional manifestations that must be detected and managed in a timely and structured manner...

There is much debate between neonatologists and paediatricians about appropriate oxygen saturation targets for babies with chronic neonatal lung disease (CNLD). Overnight oximetry is used to guide the fraction of inspired oxygen to use. We did this literature review to examine the current literature on the use of overnight oximetry in term infants, preterm infants and babies with CNLD (especially relevant to ex-preterm babies with CNLD going home on oxygen). We reviewed the literature from January 1990 to October 2017 by searching the following databases: Cochrane Central Register of Controlled Trials, The Joanna Briggs Institute, CINAHL, MEDLINE, Scopus, EMBASE, ProQuest and Science Direct...

AIM: The epidemiology of community-acquired bacterial meningitis has changed following the introduction of routine immunisation against common causative organisms. Indigenous children living in the Northern Territory, Australia, have high rates of bacterial infections. This study describes changes in the epidemiology of childhood bacterial meningitis and the distribution of the burden of disease in the Top End. METHODS: A retrospective review of cases derived from hospital medical records and laboratory data was performed...

AIM: The outcome of children with an out-of-hospital cardiac arrest is still poor, but bystander cardiopulmonary resuscitation can increase survival and minimise severe neurological sequelae. While teaching basic life support is standardised in emergency medicine classes, paediatric basic life support (PBLS) in neonates and toddlers is under-represented in paediatric curricula during university education. The appropriate mixture of E-learning and peer teaching lessons remains controversial in teaching paediatric basic skills...

AIM: To review the investigation, patterns of injury and short-term outcomes of infants younger than 12 months of age who presented more than 24 h after head injury with an isolated scalp haematoma. METHODS: A retrospective chart review of infants who presented with a head injury to the emergency department of a major paediatric hospital between 2006 and 2016. Patients were included if they presented more than 24 h after the injury, were clinically well and had a documented scalp haematoma...

AIM: To evaluate a paediatric clinical ethics service incorporating both normative and empirical analysis. METHODS: Section 1: Review of consensus guidelines to identify emerging standards for clinical ethics services (CES) and evaluation of the service in relation to these. Section 2: Description of service activity data. Section 3: Feedback from clinical staff involved in clinical ethics consultations was collected using a web-based survey. RESULTS: Four guideline documents were reviewed, and clear emerging consensus standards were identified...

AIM: Injuries involving non-motorised wheeled recreational vehicles (NMWRV) and bicycles are a common cause for hospitalisation in children. Studies show that helmet use whilst bicycle riding can decrease mortality and morbidity due to head injury. However, there remains an important proportion of children who are non-helmet users (NHU). This study aims to investigate helmet use and attitudes and injury patterns in children presenting with trauma after riding bicycles and other NMWRVs...

AIM: It is important to understand whether type 2 diabetes mellitus (T2DM) is increasing in childhood for health-care planning and clinical management. The aim of this study is to examine the incidence of T2DM in New Zealand children, aged <15 years from a paediatric diabetes centre, Auckland, New Zealand. METHODS: Retrospective analysis of prospectively collected data from a population-based referral cohort from 1995 to 2015. RESULTS: Hundred and four children presented with T2DM over the 21-year period...

AIM: Children with developmental disabilities are at risk of excessive screen time and are more vulnerable to sleep problems. The aim of this study was to determine the extent of screen time use in children with developmental disabilities and its relationship with sleep duration. METHODS: Consecutive children aged 6-15 years diagnosed with Diagnostic and Statistical Manual of Mental Disorders, Fourth or Fifth Edition (DSM-IV or DSM-5) developmental disabilities were recruited for this study from December 2014 to April 2015...

AIM: To estimate the non-medical out-of-pocket costs for families with a child in hospital. METHODS: This study was a survey of 225 parents of paediatric inpatients on nine wards of an Australian public paediatric teaching hospital on two separate days. Our primary outcomes were the costs associated with: (i) time taken off work to care for the child in hospital; (ii) time off work or contributed by family and friends to care for other dependents; and (iii) travel, meals, accommodation and incidental expenses during the child's stay...

AIM: Neonates are predisposed to bacterial infection which are an important cause of early childhood morbidity and mortality globally. It has been proposed that procalcitonin has significant utility as a diagnostic marker for bacterial infection in febrile neonates when compared to C-reactive protein (CRP). The aim of this study is to conduct a literature search to find the best available evidence to answer the clinical question of the utility of procalcitonin when compared to CRP as a predictor of bacterial infection in febrile neonates...

AIM: Children with obesity have a greater risk of adverse social and physical health outcomes. We examined temporal changes in body mass index (BMI) z-scores and the prevalence obesity and morbid obesity in children from 1985 to 2014. METHODS: Secondary data analysis of BMI data for children aged 7-15 years from five cross-sectional Australian datasets. Changes in age- and gender-adjusted BMI (BMI z-scores) and nutritional status were categorised using the International Obesity Task Force cut-off points...

AIM: To estimate the frequency, duration and monthly pattern of discretionary food advertising on Australian free-to-air television. METHODS: We logged 30 000 h of television collected in Adelaide during 2016 from one network that has four channels. The Australian Guide to Healthy Eating was used to identify discretionary foods. Data were examined according to all times, to children's peak viewing times (PVTs) and to when C-(children's) rated programmes may be broadcast...